Temporarily modifies the Puerto Rico Local Poverty Level.

This amendment makes permanent the authority to allow various provider types to order laboratory and radiology services.  In addition, the state adds coverage of heart and lung transplants for adults and all medically necessary transplants for children under 21 year of age within the inpatient hospital benefit.  

Updates the fee schedule to add two EPSDT counseling codes, effective January 1, 2021. 

This SPA seeks to confirm that the state covers all preventive services assigned a grade of A or B by the U.S. Preventive Services Task Force (USPSTF), and all approved adult vaccines and their administration recommended by the Advisory Committee on Immunization Practices (ACIP), without any cost-sharing in order to demonstrate compliance with Section 4106 of the Affordable Care Act. 

This state plan amendment is to amend the provisions governing hospice services provided concurrently with life-prolonging treatments to individuals under age 21 in order to update existing terminology and reflect current practices, and to comply with federal requirements which allow for pediatric concurrent care

Updates the fee schedule to increase the reimbursement for cardiac catheterization to 80% of the annual non-rural Medicare rate, effective January 1, 2021. 

This SPA establishes coverage and reimbursement of rehabilitation residential substance use disorder (SUD) services in a non-IMD facility.

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to pay a one time supplemental payments to chronic disease and rehabilitation inpatient hospitals.